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Biomedical subjects

M Fukui

Publications and source records attributed to M Fukui.

At least 217 records · Page 12Linked to original sources
PubMed1998

Familial occurrence of moyamoya disease in the mother and four daughters including identical twins.

Familial occurrence of moyamoya disease is described in the mother and four daughters, including identical twins. Physical examination findings on admission were all normal and no mental retardation was observed. The third daughter had suffered from a ventricular septal defect when aged 6 years, but the others all had unremarkable past histories. Four of the five patients presented with transient ischemic attack as the initial symptoms, but one patient remains asymptomatic. Two patients had had repeated transient ischemic attacks. Cerebral angiography revealed either stenosis or occlusion of the intracranial portion of the bilateral internal carotid arteries associated with moyamoya vessels in all patients. The findings of moyamoya disease in a parent and four siblings including identical twins suggest that genetic factors are important in the pathogenesis of moyamoya disease.

Adolescent↗
PubMed1998

Surgery of angiomas in the brainstem with a stress on the presence of telangiectasia.

This report deals with the surgery of angiomas other than arteriovenous malformation in the brainstem. The surgical cases were three cavernomas, two telangiectasias, and two venous malformations. We performed surgery when an angioma bled and the resulting hematoma was situated near the surface of the brainstem or the fourth ventricle. The cases were operated on at the subacute or chronic stages after hemorrhage. Although a magnetic resonance (MR) image showed a subacute or chronic localized hematoma with a low intensity rim, the case was not always a cavernoma, but a telangiectasia. Cavernomas could be totally removed, but telangiectasia could not. In the cases of medullary venous malformation the diagnosis was obtained radiologically, and when the hematoma was large, only hematoma evacuation was performed. In all cases the postoperative Karnofsky scores were improved or unchanged. Postoperative rebleeding in the hematoma cavity continued insidiously in a case of telangiectasia. The abnormal vessels of telangiectasia in the brainstem were preoperatively not visualized by cerebral angiography or MR imaging, but became visualized by enhanced MR imaging after evacuation of hematoma in two cases. It is stressed that an angioma with a hematoma intensity core surrounded by a low intensity rim on MR images is not always a cavernoma, but possibly is a telangiectasia.

Adolescent↗
PubMed1998

An indirect revascularization method in the surgical treatment of moyamoya disease--various kinds of indirect procedures and a multiple combined indirect procedure.

The indirect non-anastomotic bypass procedures for moyamoya disease are herein reviewed, and our multiple combined indirect procedure, i.e. a fronto-parieto-temporal combined indirect bypass procedure, is also introduced. Direct procedures such as superficial temporal artery-middle cerebral artery anastomosis are able to form collaterals with a high reliability, but these procedures are often difficult to technically perform in small children, and complications, when they occur, tend to be severe. Indirect procedures, such as encephalo-duro-arterio-synangiosis (EDAS), encephalo-myo-synangiosis (EMS), and encephalo-myo-arterio-synangiosis (EMAS) etc., are safe and easy and also successfully form collaterals especially in children with moyamoya disease. However, there are a few drawbacks with such procedures. They do not always form sufficient collaterals. The area where the original EDAS using the posterior branch of the superficial temporal artery can be done is also limited. Moreover, because the area covered by each single procedure is small, the collateral formation obtained by a single procedure is not always satisfactory. For these reasons we developed a fronto-temporoparietal combined indirect bypass procedure for child patients in order to overcome these problems. This multiple combined indirect procedure can cover a wider area of the ischemic brain through the EMAS in the frontal and the EDAS and EMS in the temporo-parietal regions. It is also safe and easy to perform, and one or two of these three procedures form sufficient collaterals with a relatively high reliability. This technique is described and the results are presented.

Cerebral Revascularization↗
PubMed1998

Thiamine-deficient lactic acidosis with brain tumor treatment. Report of three cases.

Lactic acidosis due to thiamine deficiency is known to complicate chemotherapy and radiotherapy treatment of malignant extracranial tumors, but to the authors' knowledge, this complication has not been reported in patients treated for malignant brain tumors. They report three such cases, demonstrating that this complication can occur during treatment of brain tumors. In all patients, consciousness levels deteriorated within 1 to 2 days. Serum lactic acid levels increased to concentrations between 62 and 96.7 mg/dl, resulting in severe metabolic acidosis. A low blood thiamine level (9 ng/ml) was demonstrated at the onset in one case, and high-dose thiamine infusions dramatically improved lactic acidemia as well as impairment of consciousness in two cases. In the other case, hydrocephalus was suspected initially, resulting in a delay in thiamine supplementation. Clinical differentiation of this form of lactic acidosis from hydrocephalus or tumor progression can be very difficult in a patient undergoing treatment for a malignant brain tumor. Demand for thiamine is thought to be increased in patients with malignant brain tumors, and supplemental thiamine during treatment is necessary to prevent lactic acidosis. When this complication occurs, immediate treatment with sufficient thiamine is essential, together with normalization of pH by using sodium bicarbonate. With timely intervention, the level of consciousness can recover to the preacidotic state with no new neurological deficits.

Acidosis, Lactic↗
PubMed1998

Effect of emeriamine, an inhibitor of fatty acid oxidation, on metabolic fate of a geometrical isomer of linoleic acid in perfused rat liver.

To estimate the relative significance of exogenous vs. endogenous fatty acids in increasing hepatic triacylglycerol secretion following an inhibition of fatty acid oxidation by emeriamine, livers from 2-d-fasting rats were perfused with or without an inhibitor in the presence of a geometrical isomer of linoleate (linolelaidic acid, trans,trans-9,12-octadecadienoic acid). Emeriamine added to the perfusion medium at 2 h of the recirculating perfusion period caused immediate and complete cessation of ketone body production while it increased triacylglycerol and cholesterol secretion by the liver without affecting uptake of exogenous linolelaidic acid. The increase in the triacylglycerol secretion by emeriamine was accompanied by a marked increase in the proportion of linolelaidic acid in this lipid molecule in the perfusate and in the liver. The calculated amounts of exogenous linolelaidate, compared with those of endogenous fatty acids in the secretory triacylglycerol, suggested that the former compared with the latter contributes more to the drug-mediated increase in triacylglycerol secretion. This drug caused a marked reduction of mitochondrial carnitine palmitoyltransferase activity in perfused liver. These results suggest that a blockade of fatty acid oxidation by emeriamine, through an inhibition of carnitine palmitoyltransferase, diverts predominantly the exogenous free fatty acids from oxidation to the esterification pathway and subsequently stimulates the synthesis and secretion of triacylglycerol-rich lipoproteins.

3-Hydroxybutyric Acid↗
PubMed1998

Inhibition in a microgravity environment of the recovery of Escherichia coli cells damaged by heavy ion beams during the NASDA ISS phase I program of NASA Shuttle/Mir mission no. 6.

We participated in a space experiment, part of the National Space Development Agency of Japan (NASDA) Phase I Space Radiation Environment Measurement Program, conducted during the National Aeronautics and Space Administration (NASA) Shuttle/Mir Mission No. 6 (S/MM-6) project. The aim of our study was to investigate the effects of microgravity on the DNA repair processes of living organisms in the in orbit. Heavy ion beam radiation- or ç-irradiation-damaged biological samples of Escherichia coli and the radioresistant bacterium Deinococcus radiodurans were prepared and placed in a biospecimen box, which was loaded into the RRMD III sensor unit of the Space Shuttle. Two identical sets of samples were left in the Spacehab's Payload Processing Facility (SPPF) in Florida, USA, as a control. (flight No. STS-84) was launched from NASA John F. Kennedy Space Center (KSC) in Florida, USA, on May 15, 1997. The mission duration was 9.22 days. An astronaut activated the biological samples in the biospecimen box in the Spacehab during orbit in order to start repair of the DNA damaged by heavy ion beams or ç-irradiation and the samples were incubated for 19 h 35 min at about 22ûC, the cabin temperature. The control specimens in the SPPF were subjected to the same treatment under terrestrial gravity. After returned to earth, we investigated cell recovery by comparing the repair of the radiation-damaged DNA of E. coli and D. radiodurans in the microgravity environment in space with that on Earth. The results indicated that the DNA repair process of E. coli, but not of D. radiodurans, cells was inhibited in a microgravity environment.

Cell Survival↗
PubMed1998

[Efficacy of the fluid attenuated inversion recovery (FLAIR) sequence of MRI as a preoperative diagnosis of hippocampal sclerosis].

A newly advanced MRI pulse sequence, the FLAIR (fluid attenuated inversion recovery) imaging, in which a long TE spin echo sequence is used with suppression of the CSF with an inversion pulse, displays the CSF space as a no-signal intensity area. There have been only a few reports on the FLAIR pulse sequence of temporal lobe epilepsy (TLE) as yet. We examined 9 cases of intractable TLE by FLAIR images and analyzed the advantages and disadvantages of the FLAIR pulse sequence for decision making on temporal lobectomy. All patients underwent anterior temporal lobectomy with hippocampectomy, and the diagnoses were confirmed histologically after surgery. Abnormally high T2 signals (HT2S) were more conspicuous with the FLAIR sequence than with any of the conventional sequences. Tilted axial plane, orientated along to the long axis of the hippocampal body, clearly demonstrated hippocampal atrophy (HA). Selection of a FLAIR sequence into the routine MR examination of patients with TLE is recommended.

Adolescent↗
PubMed1998

PET evaluation of cerebral hemodynamics in occlusive cerebrovascular disease pre- and postsurgery.

UNLABELLED: We studied cerebral blood flow (CBF), oxygen extraction fraction (OEF), transit time (TT) and hemodynamic reserve capacity using acetazolamide (ACZ) in both the pre- and postoperative states, and evaluated the effect of surgery on the cerebral hemodynamics. METHODS: Twelve patients with a unilateral occlusive cerebral artery were studied. Among them, seven patients had extracranial-intracranial (EC-IC) bypass surgery, while the remaining five patients had carotid endarterectomies. The CBF was measured using the (15)O-water bolus injection method in a resting state, 5 and 20 min after intravenous ACZ (1 g), while the OEF and TT were measured by the (15)O steady state method. The values of these parameters were obtained by regions of interest set over the cerebral hemisphere on both sides, and which then were compared between the pre- and postoperative states using the paired Student's t-test. RESULTS: The t values were 1.36 (CBF at rest), 2.97 (CBF at 5 min after intravenous ACZ), 1.40 (CBF at 20 min after intravenous ACZ), 2.00 (OEF) and -0.86 (TT) on the surgical side, and -0.16, 0.21, 0.22, -0.47 and 0.61 on the nonsurgical side, respectively. The t values of the ACZ response (% increase in CBF) were 3.07 (5 min after intravenous ACZ) and 0.72 (20 min) on the surgical side, and 1.03 and 0.90 on the nonsurgical side, respectively. A significant change was observed only in the CBF studies 5 min after intravenous ACZ. CONCLUSION: PET can demonstrate significant cerebral hemodynamic change after surgery, especially in CBF measurement 5 min after intravenous ACZ, and may therefore be useful for evaluating cerebral hemodynamics pre- and postsurgery.

Acetazolamide↗
PubMed1998

[Epstein-Barr virus-associated malignant lymphoma in an immuno-deficiency patient: a case report].

Human infection with Epstein-Barr (EB) virus occurs commonly, and EB virus exists in the B cell as a cryptic infection. Infected B cells become immortal by expressing both the EBNA2 and the LMP1 genes derived from the EB virus. Under normal condition of cellular immunity, the T cells recognize the EBNA2 and LMP1 as foreign proteins and attack the immortal B cells. However, under the condition of immunodeficiency, the immortal B cells can proliferate and form a tumor. We report a case of malignant lymphoma associated with immuno-deficiency which may correspond to this mechanism. A 33-year-old woman, who had an immuno-deficiency due to treatment for leukemia, had a progressing hemiparesis on her left extremities. Magnetic resonance imagings revealed a ring enhanced tumor with massive brain edema in the right fronto-parietal lobe. Stereotactic biopsy was performed and histological examination showed it to be a malignant lymphoma. The tumor cells were positive for L26 (B cell marker), CD79a LMP1, and EBNA2. They were negative for UCHL-1 and CD3 (T cell marker). According to these results, this lymphoma was caused by EB virus infection under the condition of immuno-deficiency.

Adult↗
PubMed1998

[Two cases of mesial temporal lobe epilepsy associated with old intracerebral hemorrhage in the lateral temporal lobe without "dual pathology"].

Two cases of intractable temporal lobe epilepsy associated with old intracerebral hemorrhage in the lateral temporal lobe were reported. Although preoperative magnetic resonance imaging (MRI) failed to reveal hippocampal atrophy with T2 hyperintensity, electrocorticographic (ECoG) recording with chronic invasive subdural electrodes indicated the mesial temporal lobe to be an ictal onset zone. After anterior temporal lobectomy involving the lesion and hippocampectomy, the patients became seizure-free. Hippocampal sclerosis, namely "dual pathology", was not noted on histological examination. Careful ECoG recording with chronic subdural electrodes is mandatory even when the preoperative MRI does not demonstrate the radiological hippocampal sclerosis.

Adult↗
PubMed1998

Carbon-11-methionine PET in focal cortical dysplasia: a comparison with fluorine-18-FDG PET and technetium-99m-ECD SPECT.

UNLABELLED: Focal cortical dysplasia is one of the known neuronal migration disorders and has recently been recognized as a cause of intractable epilepsy. In this study, we assessed the 11C-methionine (MET) uptake in focal cortical dysplasia by PET, and then compared the results with that of 18F-fluoro-2-deoxy-D-glucose (FDG) PET and 99mTc-ethyl cysteinate dimer (ECD) SPECT. METHODS: Four patients (3 men, 1 woman; age range 16-68 yr) were examined by PET and SPECT for a presurgical examination of medically intractable seizures. In all 4 patients, 11C-MET PET was performed for 15 min, started 15 min after the administration of 511-662 MBq MET. In 3 of 4 patients, FDG PET was performed for 15 min, and started 20 min after the administration of 185-370 MBq FDG. In all 4 patients, the cerebral blood flow was also evaluated by 99mTc-ECD SPECT for 15 min after the administration of 600 MBq ECD. RESULTS: In MET PET, all 4 lesions were visually recognized to have high MET uptake areas. The MET uptake of the lesions was 1.44 +/- 0.30 for the standardized uptake value (SUV) (ranging from 0.99-1.61). In FDG PET, 2 lesions were demonstrated to have low uptake areas (3.82 in SUV) while 1 had an ictal high uptake (4.74 in SUV). In ECD SPECT, 1 lesion demonstrated hypoperfusion and 1 ictal hyperperfusion while 2 showed no abnormalities. All 4 patients underwent a cortical resection and the microscopic examinations were consistent with those of focal cortical dysplasia but no evidence of a tumor was found. CONCLUSION: MET PET is useful for identifying focal cortical dysplasia as a high uptake area.

Adolescent↗
PubMed1998

Pharmacokinetics of cefdinir and its transfer to dialysate in patients with chronic renal failure undergoing continuous ambulatory peritoneal dialysis.

Cefdinir (CAS 91832-40-5) was administered orally as a 100-mg capsule (Cefzon) to a total of 12 patients with chronic renal failure undergoing continuous ambulatory peritoneal dialysis (CAPD) to investigate changes in the serum concentrations, excretion rate into the dialysate and serum-protein binding of cefdinir. Cmax values were 1.64-4.34 micrograms/ml, t1/2 values were 10.8-21.9 h., and AUC values were 31.1-73.1 micrograms.h/ml (0-30 h) in four patients given a single oral dose of 100 mg of cefdinir as a capsule. About 1 microgram/ml of cefdinir had still remained in the blood of all the patients 24 h after administration. The serum concentrations of cefdinir were dose-dependent in four patients of each group who were given an oral daily dose of 100 mg for 3 to 8 days and 200 mg (2 capsules) for 4 to 14 consecutive days. No marked change in laboratory test values or clinical symptoms before and after administration were observed in these dose regimes. Protein levels of 5.17-5.71 g/day were eliminated from the peritoneal dialysate and urine. Cefdinir inhibited 90 to 100% of the clinical isolates such as Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and other enteric bacteria causing catheter infection and peritonitis, and its antibacterial activity was stronger than that of amoxicillin (CAS 26787-78-0) or cefaclor (CAS 53944-73-3) against these clinical isolates.

Adult↗
PubMed1997

Antibodies to glutamic acid decarboxylase in Japanese diabetic patients with secondary failure of oral hypoglycaemic therapy.

Some patients with non-insulin-dependent (Type 2) diabetes mellitus (NIDDM) are positive for antibodies to glutamic acid decarboxylase (anti-GAD), which have been shown to be a useful marker for the diagnosis and prediction of insulin-dependent (Type 1) diabetes mellitus (IDDM). Anti-GAD positive NIDDM patients tend to develop insulin deficiency. We investigated the prevalence of anti-GAD in 200 NIDDM with secondary failure of oral hypoglycaemic therapy (SF) and 200 NIDDM well controlled by diet and/or sulphonylurea agents (NSF). Twenty-two of 200 (11%, p < 0.05) SF patients and 6 of 200 (3%) NSF patients were anti-GAD positive. The positive. The positive rate for anti-GAD was as high as 23.8% in the non-obese and insulin deficient SF patients. The SF patients with anti-GAD tended to be non-obese and to have an impaired release of endogenous insulin. The internal before development of secondary failure was not associated with the presence of anti-GAD in this study. In conclusion we found that anti-GAD was positive in as many as 11% of the SF patients, suggesting that autoimmune mechanisms may play an important role in the pathogenesis of secondary failure or sulphonylurea therapy.

Analysis of Variance↗